Coutant C, Jankowski C, Portha H, Barranger E
Département de chirurgie oncologique, Centre de lutte contre le cancer Georges-François Leclerc (CGFL), 1, rue du Professeur-Marion, 21000 Dijon, France; UFR des sciences de santé, université de Bourgogne, 7, boulevard Jeanne-d'Arc, 21000 Dijon, France.
Département de chirurgie oncologique, Centre de lutte contre le cancer Georges-François Leclerc (CGFL), 1, rue du Professeur-Marion, 21000 Dijon, France; UFR des sciences de santé, université de Bourgogne, 7, boulevard Jeanne-d'Arc, 21000 Dijon, France.
Gynecol Obstet Fertil. 2016 Jun;44(6):345-9. doi: 10.1016/j.gyobfe.2016.04.010. Epub 2016 May 24.
The main goal of preoperative chemotherapy is to reduce the size of the tumor and allow conservative treatment. Neoadjuvant treatment can affect axillary status with a downstaging in one third of the cases. For these patients, the benefit of axillary node dissection is questioned and the sentinel node biopsy (SLNB) seems to be a relevant option. However, the timing of performing SLNB is still debated especially for clinical negative patients with negative axillary ultrasound before preoperative chemotherapy. For axillary positive nodes proved by biopsy/cytology before preoperative chemotherapy, SLNB can be an option if there is a good clinical and radiological response.
术前化疗的主要目标是缩小肿瘤大小并实现保守治疗。新辅助治疗可在三分之一的病例中使分期降低,从而影响腋窝状态。对于这些患者,腋窝淋巴结清扫的益处受到质疑,前哨淋巴结活检(SLNB)似乎是一个合适的选择。然而,尤其是对于术前化疗前腋窝超声检查为临床阴性的患者,进行SLNB的时机仍存在争议。对于术前化疗前经活检/细胞学检查证实腋窝淋巴结阳性的患者,如果有良好的临床和影像学反应,SLNB可以作为一种选择。